Clinical effectiveness/child-patient and parent satisfaction of two topical fluoride treatments for caries: a randomised clinical trial.

Knowledge gaps exist regarding optimal silver diammine fluoride (SDF) regimens and the efficacy of new products for arresting dental caries in young children. We evaluated the effectiveness of 38%-SDF (SDI-RivaStar), Tiefenfluorid (TF) comparing with Placebo (P), all in conjunction with behavioural modification (BM), in preventing major complications (endodontic/extractions/pain)-a patient-centred outcome-due to early childhood caries over 12 months in children under 71-months. A six-arm, patient/parent-blinded, superiority, placebo-controlled randomised control trial at the university clinic in Riga, Latvia, from 1/9/20-31/8/22 (Protocol registration ISRCTN17005348). The trial tested six protocols, using three compounds (P/SDF/TF) under two regimes: annual and biannual (P1/P2/TF1/TF2/SDF1/SDF2) for major complications. Secondary outcomes included minor complications and parental satisfaction. All groups received BM. 373/427 randomised children (87.3%) completed the study. SDF2 had a significantly lower rate and risk of major (21.5%, OR = 0.28, 95%CI [0.11, 0.72], p < 0.05) and minor complications (OR = 0.16 (95%CI [0.05, 0.50], p = 0.002). Overall satisfaction was 96% (p > 0.05). SDF biannual application with BM effectively prevented major complications of early childhood caries and was well accepted by children and their parents. Trial registration number: ISRCTN17005348, principal investigator: Ilze Maldupa, registration date: 30/06/2021.Clinical trial registration number: ISRCTN registry: ISRCTN17005348, https://doi.org/10.1186/ISRCTN17005348 , registration date: 30/06/2021.

Potassium Iodide's Effect on Silver Diammine Fluoride Staining Properties as Measured Through Objective Color Analysis Using CIELAB.

Purpose: To determine the effect of potassium iodide (KI) on the black/gray staining caused by silver diammine fluoride (SDF) when applied to carious lesions. Methods: Extracted caries-free molar surfaces had caries induced to examine the use of SDF and SDF followed by KI (SDF+KI) on extracted permanent molars that had caries induced on their surfaces and were monitored for a period after application. To monitor the color changes, CIELAB color space readings???a color space defined by the International Commission on Illumination???were used. The system is composed of three values, of which the L* measures black to white across a span of zero (black) to 100 (white). Measurements were taken at eight intervals between days zero to 72. Results: L* values were found to be significantly different between SDF and SDF+KI groups and from baseline. On average, the SDF+KI group versus the SDF group was 9.47 units lighter. Conclusion: The findings indicate the application of silver diammine fluoride followed by potassium iodide can reduce the black staining SDF alone causes, potentially making it a viable esthetic option for patients with anterior tooth caries.

Anti Gram-Positive Bacteria Activity of Synthetic Quaternary Ammonium Lipid and Its Precursor Phosphonium Salt.

Organic ammonium and phosphonium salts exert excellent antimicrobial effects by interacting lethally with bacterial membranes. Particularly, quaternary ammonium lipids have demonstrated efficiency both as gene vectors and antibacterial agents. Here, aiming at finding new antibacterial devices belonging to both classes, we prepared a water-soluble quaternary ammonium lipid (6) and a phosphonium salt (1) by designing a synthetic path where 1 would be an intermediate to achieve 6. All synthesized compounds were characterized by Fourier-transform infrared spectroscopy and Nuclear Magnetic Resonance. Additionally, potentiometric titrations of NH3+ groups 1 and 6 were performed to further confirm their structure by determining their experimental molecular weight. The antibacterial activities of 1 and 6 were assessed first against a selection of multi-drug-resistant clinical isolates of both Gram-positive and Gram-negative species, observing remarkable antibacterial activity of both compounds against Gram-positive isolates of Enterococcus and Staphylococcus genus. Further investigations on a wider variety of strains of these species confirmed the remarkable antibacterial effects of 1 and 6 (MICs = 4-16 and 4-64 µg/mL, respectively), while 24 h-time-killing experiments carried out with 1 on different S. aureus isolates evidenced a bacteriostatic behavior. Moreover, both compounds 1 and 6, at the lower MIC concentration, did not show significant cytotoxic effects when exposed to HepG2 human hepatic cell lines, paving the way for their potential clinical application.

A Randomized Clinical Trial to Assess Caries Arrest by Using Silver Diamine Fluoride in U.S. Children: Interim Findings.

Purpose: To assess the effectiveness of 38 percent silver diamine fluoride (SDF) in arresting cavitated caries lesions in young U.S. children. Methods: Children 12 to 71 months of age with severe early childhood caries participated in this phase three, multicenter, randomized, placebocontrolled trial. SDF was applied twice (at baseline and six months), and children were followed for eight months. A planned interim analysis of only the six-month primary outcome caries arrest data, for approximately half of the cohort (680 of 1,144 children), was conducted using a generalized estimating equation model, accounting for non-independence among carious lesions within a patient. Results: Five hundred ninety-nine of the 680 participants, with 1,413 lesions, completed the six-month exam. Lesions in the SDF group demonstrated 54 percent arrest versus 21 percent in the placebo (P<0.001). Conclusions: Silver diamine fluoride was effective at arresting active cavitated lesions in this population, leading to the early stop of the trial. Final analyses of all data and other outcomes are currently underway.

Development and Application of a Multidimensional Database for the Detection of Quaternary Ammonium Compounds and Their Phase I Hepatic Metabolites in Humans.

The COVID-19 pandemic has led to significantly increased human exposure to the widely used disinfectants quaternary ammonium compounds (QACs). Xenobiotic metabolism serves a critical role in the clearance of environmental molecules, yet limited data are available on the routes of QAC metabolism or metabolite levels in humans. To address this gap and to advance QAC biomonitoring capabilities, we analyzed 19 commonly used QACs and their phase I metabolites by liquid chromatography-ion mobility-tandem mass spectrometry (LC-IM-MS/MS). In vitro generation of QAC metabolites by human liver microsomes produced a series of oxidized metabolites, with metabolism generally occurring on the alkyl chain group, as supported by MS/MS fragmentation. Discernible trends were observed in the gas-phase IM behavior of QAC metabolites, which, despite their increased mass, displayed smaller collision cross-section (CCS) values than those of their respective parent compounds. We then constructed a multidimensional reference SQLite database consisting of m/z, CCS, retention time (rt), and MS/MS spectra for 19 parent QACs and 81 QAC metabolites. Using this database, we confidently identified 13 parent QACs and 35 metabolites in de-identified human fecal samples. This is the first study to integrate in vitro metabolite biosynthesis with LC-IM-MS/MS for the simultaneous monitoring of parent QACs and their metabolites in humans.

Laser fluorescence assessment of dental caries arrest with two silver fluoride agents in patients with special needs- a preliminary report.

PURPOSE: While silver diamine fluoride has been used extensively for caries arrest and desensitising, silver fluoride (AgF) at neutral pH may also have value as a minimally invasive dental caries treatment. This study explored the effectiveness of two AgF products (AgF/KI and AgF/SnF2) when used in adult patients with special needs (SN) who had high caries risk and salivary gland hypofunction. METHODS: This split-mouth clinical study, over two appointments 3-months apart, compared the impact of a single application of AgF/KI (Riva Star Aqua, SDI) and AgF/SnF2 (Creighton Dental CSDS, Whiteley) on matched carious lesions in the same arch, by clinical visual-tactile (cVT) assessment of caries status and laser fluorescence (LF, DIAGNOdent) evaluation of bacterial load in the lesions, using repeated measures analysis. RESULTS: Twelve participants were recruited in the study. A total of 56 teeth (28 pairs) were included. Both AgF products gave a significant decrease in caries activity as measured by cVT (P < 0.0001) and LF (P = 0.0027). There were no statistically significant differences between the two AgF treatments, with response rates for improvements in active lesions of 92% in the AgF/KI arm, and 96% in the AgF/SnF2 arm. There was no effect of tooth type, lesion type, arch type, plaque metabolism and plaque area at the site level on outcomes, nor was there a clustering effect of sites in a patient level analysis. Overall, LF was superior to cVT for detecting lesions that still progressed despite treatment (P = 0.0027). CONCLUSION: A single application of AgF/KI or AgF/SnF2 has high predictability (over 90%) for achieving arrest in active caries lesions in adult patients with SN and high caries risk. Clinical assessment should use visual-tactile examination combined with LF readings to detect lesions that are still progressing and that require additional treatments. Future studies should compare these AgF modalities with SDF and explore factors such as time between applications and the need for repeated applications. TRIAL REGISTRATION: The study was registered with the Australian Clinical Trials Registry (ACTRN12621001139864p) on 23/08/2021.

Polymer-lipid hybrid nanomedicines to deliver siRNA in and against glioblastoma cells.

Small interfering RNA (siRNA) holds great potential to treat many difficult-to-treat diseases, but its delivery remains the central challenge. This study aimed at investigating the suitability of polymer-lipid hybrid nanomedicines (HNMeds) as novel siRNA delivery platforms for locoregional therapy of glioblastoma. Two HNMed formulations were developed from poly(lactic-co-glycolic acid) polymer and a cationic lipid: 1,2-dioleoyl-3-trimethylammonium-propane (DOTAP) or 3ß-[N-(N',N'-dimethylaminoethane)-carbamoyl]cholesterol (DC-Chol). After characterization of the HNMeds, a model siRNA was complexed onto their surface to form HNMed/siRNA complexes. The physicochemical properties and siRNA binding ability of complexes were assessed over a range of nitrogen-to-phosphate (N/P) ratios to optimize the formulations. At the optimal N/P ratio of 10, complexes effectively bound siRNA and improved its protection from enzymatic degradation. Using the NIH3T3 mouse fibroblast cell line, DOTAP-based HNMeds were shown to possess higher cytocompatibility in vitro over the DC-Chol-based ones. As proof-of-concept, uptake and bioefficacy of formulations were also assessed in vitro on U87MG human glioblastoma cell line expressing luciferase gene. Complexes were able to deliver anti-luciferase siRNA and induce a remarkable suppression of gene expression. Noteworthy, the effect of DOTAP-based formulation was not only about three-times higher than DC-Chol-based one, but also comparable to lipofectamine model transfection reagent. These findings set the basis to exploit this nanosystem for silencing relevant GB-related genes in further in vitro and in vivo studies.

Effects of a bitter substance, denatonium benzoate, on pancreatic hormone secretion.

There is increasing evidence linking bitter taste receptor (BTR) signaling to gut hormone secretion and glucose homeostasis. However, its effect on islet hormone secretion has been poorly characterized. This study investigated the effect of the bitter substance, denatonium benzoate (DB), on hormone secretion from mouse pancreatic islets and INS-1 832/13 cells. DB (0.5-1 mM) augmented insulin secretion at both 2.8 mM and 16.7 mM glucose. This effect was no longer present at 5 mM DB likely due to the greater levels of cellular apoptosis. DB-stimulated insulin secretion involved closure of the KATP channel, activation of T2R signaling in beta-cells, and intraislet glucagon-like peptide-1 (GLP-1) release. DB also enhanced glucagon and somatostatin secretion, but the underlying mechanism was less clear. Together, this study demonstrates that the bitter substance, DB, is a strong potentiator of islet hormone secretion independent of glucose. This observation highlights the potential for widespread off-target effects associated with the clinical use of bitter-tasting substances.NEW & NOTEWORTHY We show that the bitter substance, denatonium benzoate (DB), stimulates insulin, glucagon, somatostatin, and GLP-1 secretion from pancreatic islets, independent of glucose, and that DB augments insulin release via the KATP channel, bitter taste receptor signaling, and intraislet GLP-1 secretion. Exposure to a high dose of DB (5 mM) induces cellular apoptosis in pancreatic islets. Therefore, clinical use of bitter substances to improve glucose homeostasis may have unintended negative impacts beyond the gut.

Research on carbon and nitrogen removal of tetramethylammonium hydroxide containing wastewater by combined anaerobic/integrated fixed film activated sludge process.

Tetramethylammonium hydroxide (TMAH) is widely used as a developer and etchant in the thin-film transistor liquid crystal display industry, which is the main component of developer wastewater with low C/N ratio. This study investigated TMAH degradation by combined anaerobic/integrated fixed film activated sludge (A/IFAS) process, especially for nitrogen removal. Effects of process condition on the TMAH degradation were studied, including dissolved oxygen concentration in IFAS reactor and the temperature of anaerobic reactor. Especially, the nitrogen removal was studied through the monitoring of intermediate products during TMAH biodegradation. The results indicated that lower the anaerobic treatment temperature can provide more available organic matters to enhance the denitrification in the subsequent IFAS reactor. Less oxygen supply in the IFAS reactor contributed to simultaneous nitrification and denitrification. Removal efficiency of total organic carbon and total nitrogen was up to 95.8% and 80.7%, when the temperature of anaerobic treatment was controlled at 30 °C with the DO kept at 0.7 mg/L. It indicated that A/IFAS process was efficient in carbon and nitrogen removal for TMAH degradation. The results also confirmed intermediate products of TMAH biodegradation can be used as the electron donor during denitrification, including trimethylamine, dimethylamine and methylamine. Illumina MiSeq sequencing showed that Proteobacteria was the dominant phylum contribute to nitrogen removal. Compared to sludge flocs in IFAS reactor, richer community and higher microbial diversity were observed in the biofilm.

Stabilization of heavy metals in solid waste and sludge pyrolysis by intercalation-exfoliation modified vermiculite.

Increasing amounts of solid waste and sludge have created many environmental management problems. Pyrolysis can effectively reduce the volume of solid waste and sludge, but there is still the problem of heavy metal contamination, which limits the application of pyrolysis in environmental management. The intercalated-exfoliated modified vermiculite (IEMV) by intercalators of sodium dodecylbenzene sulfonate, hexadecyltrimethylammonium bromide and octadecyltrimethylammonium bromide were used to control the release of Cd, Cr, Cu, Zn and Pb during pyrolysis process of sludge or solid waste. The retention of heavy metals in sludge was generally better than that in solid waste. The IEMV by octadecyltrimethylammonium bromide as the intercalator calcined 800 °C (STAB-800) was the best additive for heavy metal retention, and the retention of Cr, Cu and Zn was significantly better than that of Pb and Cd. Cr, Cu, Zn and Pb were at low risk, while Cd had considerable risk under certain circumstances. New models were proposed to comprehensively evaluate the results of the risk and forms of heavy metals, and the increasing temperature was beneficial in reducing the hazards of heavy metals by the addition of STAB-800. The reaction mechanism of heavy metals with vermiculite was revealed by simulation of reaction sites, Fukui Function and Frontier Molecular Orbital. Thermal activation-intercalated-exfoliated modified vermiculite (T-IEMV) is more reactive and had more active sites for heavy metals. Mg atoms and outermost O atoms are the main atoms for T-IEMV to react with heavy metals. The Cr, Cu and Zn have better adsorption capacity by T-IEMV than Pb and Cd. This study provides a new insight into managing solid waste and sludge and controlling heavy metal environmental pollution.

Investigating cationic and zwitterionic successive multiple ionic-polymer layer coatings for protein separation by capillary electrophoresis.

Successive multiple ionic-polymer layers (SMILs) have long since proved their worth in capillary electrophoresis as they ensure stable electroosmotic flow (EOF) and relatively high separation efficiency. Recently, we demonstrated that plotting the plate height (H) against the solute migration velocity (u) enabled a reliable quantitative evaluation of the coating performances in terms of separation efficiency. In this work, various physicochemical and chemical parameters of the SMIL coating were studied and optimized in order to decrease the slope of the ascending part of the H vs u curve, which is known to be controlled by the homogeneity in charge of the coating surface and by the possible residual solute adsorption onto the coating surface. SMILs based on poly(diallyldimethylammonium chloride) (PDADMAC) and poly(sodium styrene sulfonate) (PSS) were formed and the effect of each polyelectrolyte molar mass and of the number of polyelectrolyte layers (up to 21 layers) was studied. The use of polyethylene imine as an anchoring first layer was considered. More polyelectrolyte couples based on PDADMAC, polybrene, PSS, poly(vinyl sulfate), and poly(acrylic acid) were tested. Finally, zwitterionic polymers based on the poly(α-l-lysine) scaffold were synthesized and used as the last layer of SMILs, illustrating their ability to finetune the EOF, while maintaining good separation efficiency.

Enhancing brilliant green dye removal via bio composite chitosan and food-grade algae capsulated ruthenium metal-organic framework: Optimization of adsorption parameters by box-behnken design.

A natural material made of chitosan (CS) and algae (food-grade algae, FGA) was cross-linked and loaded onto a ruthenium metal organic framework to create a bio-adsorbent (Ru-MOF@CS/FGA composite sponge) with the aim of adsorbing and eliminating Brilliant green (BG) from aqueous solutions. A range of methods were employed to analyze the Ru-MOF@CS/FGA composite sponge, such as X-ray photoelectron spectroscopy (XPS) for elemental analysis, Fourier transform infrared spectroscopy (FTIR) to ascertain the function groups, and scanning electron microscopy (SEM) to establish the surface morphology, and powder X-ray diffraction (PXRD) to study of single and multi-phase polycrystalline materials. Brunauer-Emmett-Teller surface area (BET) confirmed the adsorbent's high surface area and pore volume (826.85 m2/g and 1.28 cm3/g, respectively) and decreased to 475.62 m2/g and 0.74 cm3/g after adsorption. Determine the several factors that affect the adsorption process, such as pH, the adsorbent's dose, the initial BG concentration, and the effect of salinity. The adsorption process was fitted to pseudo-second-order kinetics and Langmuir isotherms. Dubinin-Radushkevich analysis revealed that the adsorption energy was 23.8 kJ/mol, indicating chemisorption as the mode of adsorption. It was discovered through examining the impact of temperature and computing positive-charged enthalpy and entropy that the adsorption process was endothermic, meaning that it increased in response to temperature. It is possible to reuse the Ru-MOF@CS/FGA composite sponge six times with acceptable efficiency, no change in its chemical composition, and comparable FT-IR, XPS, and XRD data before and after each reuse. Examine the mechanisms of adsorbent-adsorbate interaction, which may involve H-bonding, n-π stacking, electrostatic forces, and pore filling. The adsorption results were optimized with the Box Behnken-design (BBD).

Fluorescence correlation spectroscopy in the study of the interaction between hyaluronan and positively charged surfactants.

The interaction between fluorescently labeled hyaluronan and cationic surfactants was studied using Fluorescence Correlation Spectroscopy. The hyaluronan was selected at two different molecular weights - specifically, 274 kDa and 710 kDa. Cetyltrimethylammonium bromide and Septonex® were chosen as cationic surfactants to interact with the negatively charged biopolymer. The study focused on changes in the diffusive behavior of a biopolymer that interacts with surfactant molecules in an aqueous environment. Various methods were applied to evaluate the obtained data, these including, among others, the Maximum Entropy Method, which provides the distributional dependences of diffusion coefficients. Without the surfactant, the studied biopolymers showed diffusion behavior comparable to that found in previously published studies. In the presence of surfactants, more intense interaction was observed between Cetyltrimethylammonium bromide and Septonex®. Comparing the molecular weights, the retention of intermolecular aggregates after the precipitation region for the lower weight and the disintegration of these aggregates for the higher weight were observed; moreover, they showed diffusion behavior comparable to the samples without the presence of the surfactant.

Noninferiority of Silver Diamine Fluoride vs Sealants for Reducing Dental Caries Prevalence and Incidence: A Randomized Clinical Trial.

Importance: Dental caries is the world's most prevalent noncommunicable disease and a source of health inequity; school dental sealant programs are a common preventive measure. Silver diamine fluoride (SDF) may provide an alternative therapy to prevent and control caries if shown to be noninferior to sealant treatment. Objective: To determine whether school-based application of SDF is noninferior to dental sealants and atraumatic restorative treatment (ART) in the prevalence of dental caries. Design, Setting, and Participants: The Silver Diamine Fluoride Versus Therapeutic Sealants for the Arrest and Prevention of Dental Caries in Low-Income Minority Children (CariedAway) study was a pragmatic noninferiority cluster-randomized clinical trial conducted from February 2018 to June 2023 to compare silver diamine fluoride vs therapeutic sealants for the arrest and prevention of dental caries. Children at primary schools in New York, New York, with at least 50% of the student population reporting as Black or Hispanic and at least 80% receiving free or reduced lunch were included. This population was selected as they are at the highest risk of caries in New York. Students were randomized to receive either SDF or sealant with ART; those aged 5 to 13 years were included in the analysis. Treatment was provided at every visit based on need, and the number of visits varied by child. Schools with preexisting oral health programs were excluded, as were children who did not speak English. Of 17 741 students assessed for eligibility, 7418 were randomized, and 4100 completed follow-up and were included in the final analysis. Interventions: Participants were randomized at the school level to receive either a 38% concentration SDF solution or glass ionomer sealants and ART. Each participant also received fluoride varnish. Main Outcomes and Measures: Primary study outcomes were the prevalence and incidence of dental caries. Results: A total of 7418 children (mean [SD] age, 7.58 [1.90] years; 4006 [54.0%] female; 125 [1.7%] Asian, 1246 [16.8%] Black, 3648 [49.2%] Hispanic, 153 [2.1%] White, 114 [1.5%] multiple races or ethnicities, 90 [1.2%] other [unspecified], 2042 [27.5%] unreported) were enrolled and randomized to receive either SDF (n = 3739) or sealants with ART (n = 3679). After initial treatment, 4100 participants (55.0%) completed at least 1 follow-up observation. The overall baseline prevalence of dental caries was approximately 27.2% (95% CI, 25.7-28.6). The odds of decay prevalence decreased longitudinally (odds ratio [OR], 0.79; 95% CI, 0.75-0.83) and SDF was noninferior compared to sealants and ART (OR, 0.94; 95% CI, 0.80-1.11). The crude incidence of dental caries in children treated with SDF was 10.2 per 1000 tooth-years vs 9.8 per 1000 tooth-years in children treated with sealants and ART (rate ratio, 1.05; 95% CI, 0.97-1.12). Conclusions and Relevance: In this school-based pragmatic randomized clinical trial, application of SDF resulted in nearly identical caries incidence compared to dental sealants and ART and was noninferior in the longitudinal prevalence of caries. These findings suggest that SDF may provide an effective alternative for use in school caries prevention. Trial Registration: ClinicalTrials.gov Identifier: NCT03442309.

Oil and Organic Liquids Incorporation into Fresh Geopolymer Pastes Using Suitable Quaternary Ammonium Surfactants.

The direct incorporation of low viscosity organic liquids (OL) such as dodecane and tributylphosphate (TBP) into fresh geopolymers (GP) is difficult and generally leads to variable amounts of un-incorporated OL remaining outside the hardened geopolymer. Experimentally, it is observed that a regular torque increase during OL incorporation corresponds to a suitable dispersion of the OL in the form of fine micrometric droplets. This can be obtained for TBP and dodecane by adding a small quantity of quaternary ammoniums salts (QAs) such as cetyltrimethylammonium bromide (CTAB). Shorter alkyl chains QAs, such as hexamethyltrimethylammonium (HMTA) can also be used but with a reduced efficiency. The positive impact of CTAB is then confirmed by the Washburn capillary rise method, showing that the interactions between TBP and CTAB-modified metakaolin are weaker compared to untreated powder. Finally, it is observed that the incorporation of TBP into geopolymer slurries is much easier than the incorporation of dodecane. The low interfacial tension measured between TBP and the activating solution (around 8 mN·m -1 ), contrasting with dodecane (29 mN·m -1 ), explains that the dispersion of TBP droplets in fresh metakaolin suspensions is more efficient.

Pharmacological prevention and treatment of opioid-induced constipation in cancer patients: A systematic review and meta-analysis.

BACKGROUND: Cancer-related pain often requires opioid treatment with opioid-induced constipation (OIC) as its most frequent gastrointestinal side-effect. Both for prevention and treatment of OIC osmotic (e.g. polyethylene glycol) and stimulant (e.g. bisacodyl) laxatives are widely used. Newer drugs such as the peripherally acting µ-opioid receptor antagonists (PAMORAs) and naloxone in a fixed combination with oxycodone have become available for the management of OIC. This systematic review and meta-analysis aims to give an overview of the scientific evidence on pharmacological strategies for the prevention and treatment of OIC in cancer patients. METHODS: A systematic search in PubMed, Embase, Web of Science and the Cochrane Library was completed from inception up to 22 October 2022. Randomized and non-randomized studies were systematically selected. Bowel function and adverse drug events were assessed. RESULTS: Twenty trials (prevention: five RCTs and three cohort studies; treatment: ten RCTs and two comparative cohort studies) were included in the review. Regarding the prevention of OIC, three RCTs compared laxatives with other laxatives, finding no clear differences in effectivity of the laxatives used. One cohort study showed a significant benefit of magnesium oxide compared with no laxative. One RCT found a significant benefit for the PAMORA naldemedine compared with magnesium oxide. Preventive use of oxycodone/naloxone did not show a significant difference in two out of three other studies compared to oxycodone or fentanyl. A meta-analysis was not possible. Regarding the treatment of OIC, two RCTs compared laxatives, of which one RCT found that polyethylene glycol was significantly more effective than sennosides. Seven studies compared an opioid antagonist (naloxone, methylnaltrexone or naldemedine) with placebo and three studies compared different dosages of opioid antagonists. These studies with opioid antagonists were used for the meta-analysis. Oxycodone/naloxone showed a significant improvement in Bowel Function Index compared to oxycodone with laxatives (MD -13.68; 95 % CI -18.38 to -8.98; I2 = 58 %). Adverse drug event rates were similar amongst both groups, except for nausea in favour of oxycodone/naloxone (RR 0.51; 95 % CI 0.31-0.83; I2 = 0 %). Naldemedine (NAL) and methylnaltrexone (MNTX) demonstrated significantly higher response rates compared to placebo (NAL: RR 2.07, 95 % CI 1.64-2.61, I2 = 0 %; MNTX: RR 3.83, 95 % CI 2.81-5.22, I2 = 0 %). With regard to adverse events, abdominal pain was more present in treatment with methylnaltrexone and diarrhea was significantly more present in treatment with naldemedine. Different dosages of methylnaltrexone were not significantly different with regard to both efficacy and adverse drug event rates. CONCLUSIONS: Magnesium oxide and naldemedine are most likely effective for prevention of OIC in cancer patients. Naloxone in a fixed combination with oxycodone, naldemedine and methylnaltrexone effectively treat OIC in cancer patients with acceptable adverse events. However, their effect has not been compared to standard (osmotic and stimulant) laxatives. More studies comparing standard laxatives with each other and with opioid antagonists are necessary before recommendations for clinical practice can be made.

Gemini Quaternary Ammonium Surfactants with Different Counterions-modified Montmorillonite for Efficient Removal of Methyl Orange.

Organic Na-montmorillonite (OMt-12-2-12·2Y - , Y=CH 3 CO 3 - , C 6 H 5 COO - and Br - ) modified by a series of Gemini quaternary ammonium surfactants with different counterions was prepared for enhancing the adsorption capacity of methyl orange. Compared with the initial adsorption capacity of 5.251 mg/g of Na-Mt, the adsorption effect of OMts under the optimal conditions increased by about 31~34 times. The adsorption isotherms and kinetics of all adsorption processes were respectively described by Langmuir and pseudo-second-order models. The structure, hydrophobicity and hydration of the counterions, as well as the affinity of the counterions with the long aliphatic chains, had a certain influence on the adsorption performance of OMts for methyl orange.

Effect of silver diamine fluoride and nano silver fluoride on oral health-related quality of life of children with early childhood caries: A randomized clinical trial.

OBJECTIVES: Untreated caries in primary teeth is one of the most prevalent health problems in children worldwide. Silver diamine fluoride (SDF) non-invasively arrests caries but causes staining unlike Nano Silver Fluoride (NSF) which causes no stains. This study compared the effect of NSF and 38 % SDF on the oral health related quality of life (OHRQoL) of preschool children after 6 months. METHODS: Children were included if they were younger than 4 years, with at least one active lesion, ICDAS score ≥3, attending nurseries in a rural area in Alexandria, Egypt. They were randomly assigned to receive NSF once at baseline, or SDF at baseline and after 6 months. The Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) was used to assess the OHRQoL. The groups were compared using chi-square test and the effect of the intervention on OHRQoL was assessed using multiple linear regression. RESULTS: 360 children were included, mean (SD) age = 42.3 (8.2) months. After 6 months, NSF had significantly lower A-ECOHIS scores than SDF in bivariate analysis (p< 0.05) and in regression analysis (B= -5.02, p = 0.001) after adjusting for confounders. There were significant reductions in the A-ECOHIS total and domains' scores in both study groups, except for the social interaction domain in the SDF group. CONCLUSION: After 6-month, both agents significantly improved children's OHRQoL although NSF had a significantly better impact on OHRQoL than SDF. CLINICAL SIGNIFICANCE: Patient-reported outcomes support the inclusion of the two agents among the options for ECC management with better effect on quality of life after NSF. TRIAL REGISTRATION: The trial was registered in the clinicaltrials.gov registry (#NCT05255913).

Interplay between autophagy and CncC regulates dendrite pruning in Drosophila.

Autophagy is essential for the turnover of damaged organelles and long-lived proteins. It is responsible for many biological processes such as maintaining brain functions and aging. Impaired autophagy is often linked to neurodevelopmental and neurodegenerative diseases in humans. However, the role of autophagy in neuronal pruning during development remains poorly understood. Here, we report that autophagy regulates dendrite-specific pruning of ddaC sensory neurons in parallel to local caspase activation. Impaired autophagy causes the formation of ubiquitinated protein aggregates in ddaC neurons, dependent on the autophagic receptor Ref(2)P. Furthermore, the metabolic regulator AMP-activated protein kinase and the insulin-target of rapamycin pathway act upstream to regulate autophagy during dendrite pruning. Importantly, autophagy is required to activate the transcription factor CncC (Cap "n" collar isoform C), thereby promoting dendrite pruning. Conversely, CncC also indirectly affects autophagic activity via proteasomal degradation, as impaired CncC results in the inhibition of autophagy through sequestration of Atg8a into ubiquitinated protein aggregates. Thus, this study demonstrates the important role of autophagy in activating CncC prior to dendrite pruning, and further reveals an interplay between autophagy and CncC in neuronal pruning.

Clinical evidence for silver diamine fluoride to reduce dentine hypersensitivity: A systematic review.

OBJECTIVE: To assess the clinical evidence for silver diamine fluoride (SDF) to reduce dentine hypersensitivity in adults. METHODS: Two independent researchers searched the English literature in five databases (Scopus, PubMed, Web of Science, EMBASE and the Cochrane Library) up to 15th July 2023 for clinical trials investigating the desensitising effect of professionally applied SDF to manage dentine hypersensitivity in adults aged 18 or above at any follow-up period. The primary outcome was the change in dentine hypersensitivity between baseline and follow-up visits after SDF application regarding any validated pain outcome measures. The Cochrane guidelines were used for the risk of bias assessment. RESULTS: Three hundred and thirty-one studies were identified, and four of them were finally included. Three of the included studies were rated as having a 'low risk' of bias. The SDF solution reduced dentine hypersensitivity in adults. The percentage reduction in dentine hypersensitivity ranged from 23 % to 56 % after a single application of SDF solution. Moreover, the SDF solution was more effective than potassium nitrate, potassium oxalate and glutaraldehyde plus hydroxyethyl methacrylate in reducing dentine hypersensitivity. Meta-analysis indicated a more significant reduction in visual analogue scales (1-10) by 1.35 (95 % CI:0.9-1.8; p<0.00001) after receiving the SDF application than controls. CONCLUSION: The included clinical trials showed that SDF solution reduced dentine hypersensitivity in adults. However, clinical trials are few, and their protocol varied from one another. Further well-designed clinical trials should be conducted to provide more evidence on its use to manage dentine hypersensitivity. CLINICAL SIGNIFICANCE: SDF is cleared as desensitizing agents by the US Food and Drug Administration to manage dentine hypersensitivity, which induces pain, limits food choice, and impacts the quality of life. Evidence from this systematic review informs clinicians and provides researchers insight for future research on SDF use for dentine hypersensitivity. THE INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS (PROSPERO) REGISTRATION NUMBER: CRD42023462613.